Donnet A, Habib M, Azorin J M
Clinique de Neurologie, CHU Timone, Marseille.
Rev Med Interne. 1990 Mar-Apr;11(2):133-41. doi: 10.1016/s0248-8663(05)82215-5.
The concept of pseudodementia was coined in the late XIXth century to refer to a syndrome mimicking dementia, but without underlying neurological lesions. Depressive disorders represent the main etiological factor and may present under two different forms, either "depressive cognitive disorders", or the more severe feature of "Wernicke's pseudodementia". The main issue remains diagnosing pseudodementia form organic dementia, especially from cortical degenerations of the Alzheimer type. Thus, the recognition of this clinical syndrome represents an alternative to the diagnosis of dementia which may lead to earlier and more effective psychiatric treatment. Recently, diagnostic criteria have been proposed to facilitate this distinction. Such criteria include clinical history, neuropsychological features, biological findings (dexamethasone suppression test and plasma MHPG) and electroencephalographic sleep studies. Finally, from a theoretical point of neurological conception of depression as well as for current hypotheses on the relationship of this last one with dementia.
假性痴呆的概念于19世纪末提出,用于指一种模仿痴呆但无潜在神经病变的综合征。抑郁障碍是主要病因,可表现为两种不同形式,即“抑郁性认知障碍”或更严重的“韦尼克假性痴呆”特征。主要问题仍然是区分假性痴呆与器质性痴呆,尤其是与阿尔茨海默型皮质变性的区分。因此,认识到这种临床综合征是痴呆诊断的一种替代方法,这可能会带来更早且更有效的精神科治疗。最近,已提出诊断标准以促进这种区分。这些标准包括临床病史、神经心理学特征、生物学检查结果(地塞米松抑制试验和血浆MHPG)以及脑电图睡眠研究。最后,从抑郁的神经学概念理论以及关于抑郁与痴呆关系的当前假说来看。